Early Detection of Septic Patient's Deterioration Based on the Modified Early Obstetric Warning Score (MEOWS)-Case...

Delayed diagnosis concerns most septic infections and results in worse prognosis. We present a case of a 35-year-old pregnant woman with two severe maternal infections in whom rapid implementation of MEOWS and further treatment avoided septic deterioration.

We report a case of a 26-week gravida that was admitted due to fever, chills, muscle pain, headache, and chest pain. Clinical examination ruled out signs of preterm labor. Elevated results of implemented MEOWS prompted rapid initiation of broad-spectrum antibiotic therapy. A microbiological examination of urine and blood confirmed Staphylococcus aureus MSSA. Quick implementation of the therapy allowed for the normalization of inflammatory parameters, and the patient was discharged. Three days after, she returned with similar, flu-like signs. As with the first admission, the increase in the MEOWS score preceded the increase in inflammatory parameters. The patient went into premature labor at 30 weeks of gestation. Although histopathological examination of the placenta revealed inflammatory features, the source of infection has not been identified. Continuation of antibiotic therapy normalized inflammatory parameters, and she was discharged 8 days after the delivery.

Delayed diagnosis is one of the most relevant factors affecting prognosis of maternal sepsis. The use of MEOWS may accelerate the decision to implement therapy and reduce maternal morbidity and mortality.